Stephen Hawking: I’m worried about the future of the NHS

Stephen Hawking at the Royal Society of Medicine

Stephen Hawking has said he is worried about the future of the NHS, in a speech critical of government policy and Health Secretary Jeremy Hunt.

The Cambridge University scientist, who publicly backed Labour in the election, accused Mr Hunt of “cherry-picking” evidence to support his policies.

The 75-year-old also said he was concerned about the involvement of the private sector in the NHS in England.

But Mr Hunt said some of Mr Hawking’s comments were “pernicious”.

A statement released by the Department of Health after the text of the speech was given to the BBC in advance said extra money was being invested in the NHS and it had recently been ranked as a top-performing health system.

Prof Hawking, who has had motor neurone disease for most of his adult life that has impaired his movement and ability to speak, delivered the speech at a conference at the Royal Society of Medicine in London, organised to air concerns about the future of the NHS.

The author of A Brief History of Time, who is a Labour supporter, said he had been motivated to speak because of the role the health service has played in his life, saying if it was not for the NHS he “wouldn’t be here today”.

In the speech, Prof Hawking listed a number of occasions on which the NHS was there for him.

This included an episode in 1985 when he caught pneumonia in Switzerland.

Doctors there suggested his ventilator be turned off to end his life, but his wife refused and he was flown back to Addenbrooke’s hospital in Cambridge where he received treatment and recovered.

Fourteen years after that, he had pioneering throat reconstruction surgery in London after his condition worsened and he was struggling to eat and breathe.

“I have had a lot of experience of the NHS and the care I received has enabled me to live my life as I want and to contribute to major advances in our understanding of the universe,” he said, referring to his theories on black holes and the origin of the Universe.

His speech then listed some of the developments in the NHS that concerned him, including the move toward what he called a “US-style insurance system”.

He said he believed there had been an increase in private provision of care, including the use of agency staff, that was leading to profit being extracted from the health service.

“The more profit is extracted from the system, the more private monopolies grow and the more expensive healthcare becomes. The NHS must be preserved from commercial interests and protected from those who want to privatise it,” he said.

He said that a publicly provided, publicly run system was the “most efficient” and so those who say we cannot afford the NHS are wrong.

“We cannot afford not to have the NHS,” he added.


His speech also mentioned Mr Hunt by name.

In a section about the move towards a seven-day NHS, Prof Hawking said that while he would like there to be more services available at weekends, the government has failed to carry out “proper due diligence”, particularly with regard to whether there would be enough staff.

He quoted from a letter he put his name to last year explaining how Mr Hunt “cherry-picked” research to put his case.

The health secretary initially said on Twitter that Mr Hawking was a “brilliant physicist but wrong on the lack of a weekend effect” in the NHS.

He also said the associated with weekend NHS services was “the most comprehensive ever”.

But hours later he posted two further tweets, in which he said Mr Hawking’s concerns, about the development in the UK of the type of insurance system seen in the United States, were a “pernicious falsehood”.

He also said the Conservatives had provided the NHS with more money and medical staff than ever before.

Skip Twitter post by @Jeremy_Hunt

Most pernicious falsehood from Stephen Hawking is idea govt wants US-style insurance system.Is it 2 much to ask him to look at evidence? 1/2

— Jeremy Hunt (@Jeremy_Hunt) August 19, 2017

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End of Twitter post by @Jeremy_Hunt

Skip Twitter post 2 by @Jeremy_Hunt

NHS under Cons has seen more money,more docs and more nurses than ever in history.Those with private med insurance DOWN 9.4% since 2009! 2/2

— Jeremy Hunt (@Jeremy_Hunt) August 19, 2017

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End of Twitter post 2 by @Jeremy_Hunt

The Department of Health responded to Mr Hawking’s comments by pointing out that the numbers of staff working in the NHS were increasing and it “makes no apology” for tackling the weekend effect.

The statement pointed out that only about 8% of NHS funding goes to the private sector.

It also said that “despite being busy”, the NHS had been ranked as the “best, safest and most affordable healthcare system out of 11 wealthy nations” in a recent study by the Commonwealth Fund.

“The government is fully committed to a world-class NHS, free at the point of use now and in the future – that’s why we’re backing it with an extra £8bn of investment over the next five years,” the statement said.

Calories in popular foods must be cut, say health officials

Junk food

Targets are to be set to reduce calories in pizzas, burgers and ready meals as part of the government’s drive to tackle child obesity in England.

Health officials believe the move is needed as people are consuming 200 to 300 calories too many each day.

It could see the size of products reduced or ingredients changed in food and drinks bought in supermarkets, takeaways and restaurants.

The targets are expected to be set by Public Health England within a year.

They will be voluntary, although officials at the government advisory body said if the industry did not respond they were prepared to legislate.


  • 260 in a typical burger with cheese in a bun
  • 880 in a 10-inch takeaway pizza
  • 237 in a Krispy Kreme chocolate iced ring doughnut
  • 338 in a Greggs tuna mayonnaise white sub roll
  • 54 in a 400g tin of Heinz spaghetti

Source:


The calorie-reduction programme comes after the success of the decade-long drive to reduce salt content in food.

It will be modelled on the sugar-reduction programme that was included in last year’s child obesity strategy and which committed the industry to reducing the amount of sugar in certain foods by 20% by 2020.

PHE chief nutritionist Dr Alison Tedstone said good progress was being made on the sugar target and it was now time to consider tackling calories.

She pointed out that only a quarter of calories come from sugary foods so if successful it could have a major impact.

“We have a serious problem – one in three leave primary school either obese or overweight,” she said.

“If we want to tackle this we have to look at calories. There are a number of ways it can be done – we can reduce the size of the products or change the ingredients.”




  • As a guide, an average man needs around 2,500 calories a day to maintain a healthy body weight
  • For an average woman, that figure is around 2,000
  • These values can vary depending on age, size and levels of physical activity, among other factors
  • School-age children are advised to consume anywhere between 1,600 and 2,500
  • People on average consume between 200 and 300 calories more than they should

Source:


She also defended the child obesity strategy, which was announced last August, amid criticism from campaigners that it had failed to have the impact it should have.

Dr Tedstone said she was “delighted” with it as it was the first time there had been a cross-government commitment to tackling the issue.

The plan also included the levy on sugary drinks, which is due to come into force in April 2018.

Caroline Cerny, of the Obesity Health Alliance, said it looked forward to seeing “ambitious” targets being set to cut calories.

But she said the food industry was continuing to “get away with bombarding children with adverts that we know encourage unhealthy food choices”.

“Failing to tackle this area is significantly undermining the impact of the child obesity plan. After one year, it is scraping along with a C grade, rather than topping the class with an A star,” she added.

A spokeswoman for the Food and Drink Federation said it welcomed “broadening” the focus away from only sugar.

“Singling out the role of individual ingredients and food groups does not help consumers to make good choices about their diet, lifestyle or general health.”

She said companies were playing their part by making healthier options available and providing nutritional information on packs.

She added: “Our industry has a proud track record of reformulation to remove salt, fat and sugar from food and drinks. This work will continue as we rise to the challenge of PHE’s sugar reduction targets and engage with this new focus on calories.”

Newcastle health boss Sir Leonard Fenwick sacked

Sir Leonard Fenwick

The longest-serving chief executive in the NHS has been sacked for gross misconduct.

Sir Leonard Fenwick joined what later became Newcastle-upon-Tyne Hospitals NHS Foundation Trust in 1977, and has been on extended leave since January.

A disciplinary panel dismissed him after an investigation into claims of bullying and abusive behaviour.

Sir Leonard described it as “an orchestrated witch hunt”, but the trust denied this.

The trust has referred “a number of concerns” arising from the investigation to the NHS counter fraud team, known as NHS Protect.

Sir Leonard said this team had “yet to approach” him.

.

He said there had been pressure on him to leave and claimed ageism was at play.

“A catalogue of opportunity to undermine” him had been collected because he was “seen as yesterday, rather than tomorrow”, he said.

In response to accusations of bullying, he accepted he had a reputation for “being a little strident”.

“I do not apologise for that; I run a tight ship,” he said.

“I’m not a bully but I can show some measure of intolerance on occasions.

“There are those who may feel a little timid or a little anxious but I do look at outcomes and quality.”

He said it was “absolute nonsense” that he could swear and shout if angry and “certainly not in public setting”.

“In a private team meeting, in my close team, where, yes, I can see things drifting, I may have some strong words – but that’s management,” he said.


An investigation was carried out by an HR specialist outside the trust into “a number of issues raised by different sources”.

This led to a two-day disciplinary hearing, which found “allegations relating to inappropriate behaviour, use of resources and a range of governance issues were proven”.

The trust said the decision to dismiss Sir Leonard “was not taken lightly, but made after very careful, lengthy and detailed consideration of the investigation report and Sir Leonard’s response to the allegations”.

The trust’s latest annual report revealed Sir Leonard was paid between £245,000 and £250,000 a year, but his pension sums were no longer shown as they had been drawn and taken in a previous year.

Earlier this year claiming Sir Leonard forced the resignations of two consultants caught having sex with junior members of staff on hospital premises, with the suggestion the action alienated some staff.

The trust said it denied any suggestion the extended leave was connected to the handling of any internal disciplinary matter.

Peanut allergy treatment ‘lasts up to four years’

Peanut

An oral treatment for peanut allergy is still effective four years after it was administered, a study has found.

Children were given a probiotic, with a peanut protein, daily for 18 months.

When tested one month later, 80% could tolerate peanuts without any allergic symptoms and after four years, 70% of them were still able to eat peanuts without suffering any side-effects.

Food allergies have risen dramatically in recent decades, with peanut allergy one of the most deadly.

Lead researcher Prof Mimi Tang, of Murdoch Childrens Research Institute in Melbourne, said half the children were consuming peanuts regularly while others were only eating them infrequently.

“The importance of this finding is that these children were able to eat peanuts like children who don’t have peanut allergy and still maintain their tolerant state, protected against reactions to peanuts,” she said.

Prof Tang said it was the first time a treatment for peanut allergy had been shown to be effective for this long.

The probiotic used is called Lactobacillus rhamnosus, which has been associated with preventing certain allergic symptoms.



  • There is often confusion about when peanuts are safe as the guidelines used to advocate avoidance
  • Peanuts are now thought to be
  • If there is no family history of allergies or eczema then health officials say peanut butter and other ground or crushed nuts are OK
  • If there is a heightened risk then parents should consult a doctor
  • This research suggests careful introduction of peanut may help such children, but parents should not do this on their own
  • No child under five should eat a whole nut

The Australian research team now wants to assess whether the treatment has improved the children’s quality of life, as some 250 million people worldwide are affected by food allergy – a number which has more than trebled in the last 20 years.

Peanut allergy, which is one of the most common causes of death from food allergy, has increased at the greatest rate.

Prof Tang said the findings, published in suggest “the exciting possibility that tolerance is a realistic target for treating food allergy”.

She added: “This is a major step forward in identifying an effective treatment to address the food allergy problem in Western societies.”

Bowel cancer test: ‘No health minister’ means NI people must wait

Bowel Cancer UK

A new, more accurate screening test for bowel cancer is on hold in Northern Ireland because there is no Stormont health minister.

Bowel cancer is second only to lung cancer as the leading cause of death from the disease in both the UK and in Europe.

Up to 16,000 people in the UK die from the disease every year.

The new test is being rolled out in England, Scotland and Wales, but Northern Ireland is lagging behind.

The Department of Health said the UK recommendation for the new test was endorsed by the Northern Ireland Screening Committee in July.

Now it is up to a Northern Ireland health minister to consider it – when that minister is appointed.

“In the interim, the department and Public Health Agency will be taking forward the necessary preparatory work,” a spokesperson for the Department of Health said.

Asha Kaur, policy and campaigns manager, Bowel Cancer UK, said the new test was much more accurate and also easier to complete than the current screening test.


“This means we could potentially save more lives from bowel cancer,” she said.

The Faecal Immunochemical Test – FIT – detects tiny amounts of blood in the stool just like the current screening test.

“Where the FIT test differs is in the way that it measures the level of blood whereas the current test indicates the presence of blood so FIT is far more accurate,” she said.


“A key difference with FIT is that it requires only one sample rather than the three needed previously.

“The pilot found that FIT picks up twice as many cancers and four times as many advanced adenomas as the current screening test,” she said.

“This is important because the more cancers we can pick up early, the more lives we can save. We know that cancers picked up through the screening are more likely to be early stage cancers. The earlier bowel cancer is detected, the easier it is to treat and the greater chance of survival.”


Ms Kaur said England, Scotland and Wales have committed to replace the screening test with FIT. Scotland will introduce it first in November 2017, followed by England in 2018 and then Wales.

But Northern Ireland is waiting for a new health minister to approve it.

On average 59% of people living in Northern Ireland who are sent the bowel cancer screening test for free in the post actually complete it, but this drops to 57% in Scotland, 56% in England and 54% in Wales. Bowel Cancer UK believes this should be increased with the new easier FIT test.

“The National Screening Committee recommended the introduction of the FIT test in 2016,” said Ms Kaur.


“However, because Stormont is not currently running and ministerial approval is needed, I understand that is not forthcoming.”

A spokesperson for the Public Health Agency in Northern Ireland said current bowel cancer screening is not a test for cancer but, rather looks for blood and, as cancers often bleed, this means further investigations are recommended.

She said studies have shown that current screening reduces mortality rates from bowel cancer by 15%.

“A combination of availing of the screening programme when invited and being alert to signs and symptoms of bowel cancer can help increase the chances of the illness being caught at an earlier stage,” she said.

Maternity ‘must improve’ at baby-deaths hospital trust

Princess Royal Hospital sign

Maternity services at a health trust at the centre of a baby deaths inquiry must improve, inspectors have said.

Health Secretary Jeremy Hunt into the Shrewsbury and Telford Hospital NHS Trust in April.

A Care Quality Commission (CQC) report said overall care had got better but safety in maternity services “needed further improvement”.

The trust said challenges needed to be resolved and it wanted to work more closely with GPs.

Inspectors visited the trust’s Princess Royal Hospital, Royal Shrewsbury Hospital and its five midwife led maternity units, in December and January to check whether improvements had been made following its previous inspection in October 2014.

They found progress had been made at the trust as a whole, but gave it a “requires improvement” rating for being safe, responsive and well-led.

The CQC’s chief inspector of hospitals, Prof Ted Baker, said end-of-life care services had made “significant progress” and “a positive change in culture among staff and leaders at the trust” was noted.

But he said action was needed particularly with regard to “maintaining appropriate staffing levels in the emergency department and ensuring a strong safety and learning culture within maternity services”.

Seven babies died in a 20-month period between September 2014 and May 2016.

A at the trust by the BBC in June.

In maternity services, the watchdog found learning from “safety incidents was not always being shared with all staff” to support improvements.

It added a lack of regular post-natal ward rounds meant “high risk” post-natal women were not regularly reviewed and on the Wrekin midwife led unit, “medicines management was also a concern”.

However, the report praised “caring and compassionate staff” and rated providing effective services and caring services as “good”.


The trust said it had commissioned the Royal College of Obstetricians and Gynaecologists to help and worked with the Virginia Mason Institute in the US to improve patient safety.

It said medical care at the Royal Shrewsbury Hospital and the Princess Royal Hospital had made “significant improvement.”

But it admitted failing to hit the government’s target of admitting or transferring 95% of A&E patients within four hours.

Trust chief executive Simon Wright said the need to resolve challenges “is the driving force behind our plans to reconfigure hospital services and to work more closely with GPs”.

Meningitis jab uptake ‘worryingly low’

vaccine being given

School-leavers are putting themselves at risk of deadly meningitis if they do not take up the offer to be vaccinated against the disease, nurses are warning.

People living in England who are aged 17 and 18 are eligible for the free jab.

The Royal College of Nursing says only a third took up the offer last year.

Charlotte Hannibal, now 21, lost both her legs and all of the fingers on her left hand due to the disease.

She had just started university when she fell ill.

It started with a “headache, a bit of a sore throat”, says Charlotte, who is now an ambassador for the Meningitis Research Foundation.

Twenty-four hours later she was admitted to hospital. Doctors treated the infection, but had to amputate.


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‘Meningitis W took both my legs and half my fingers’

Older teenagers and new university students are said to be at particularly high risk of infection because they are mixing closely with lots of new people. Coughs, sneezes and kissing can spread it.


The MenACWY jab protects against four strains of meningococcal disease which cause meningitis and septicaemia – strains A, C, W and Y.

MenW, the type Charlotte had, is one of the most aggressive and life-threatening forms and can be fatal.

As well as affecting the membranes around the brain, the infection can cause life-threatening blood poisoning.

Officials say there has been a rapid increase in MenW cases across England, from 22 cases in 2009-10 to 210 in 2015-16.

Young people who have not yet had the MenACWY vaccine remain eligible up to their 25th birthday and should contact their GP surgery to get immunised.

Year 9 pupils (aged 13 to 14) are also routinely offered the jab in school.


Helen Donovan, from the RCN, said: “Meningitis can be fatal, and can leave those who survive with life-changing disabilities. Vaccination is quick, easy and free, and offers protection against most strains of the disease, but reaching young people is not easy.

“Many will have been away over the summer travelling or working before university. But the risk is real and getting vaccinated saves lives.

“We are urging people to contact their surgeries now and book an appointment with the practice nurse.”

Dr Mary Ramsay, head of immunisation at Public Health England, added: “Remain vigilant and seek urgent medical help if you think someone may be showing signs of infection.”

Time spent frail in old age ‘doubles’

Woman with her carer

The amount of time spent needing daily care at the end of life has doubled in England over the past two decades, a study suggests.

The Newcastle University study found men spent 2.4 years on average needing regular care and women three years.

This includes everything from help with washing and dressing each day to round-the-clock care.

Researchers said it suggested there needed to be a sharp increase in the number of care home places to cope.

It comes as ministers consider a new way to fund the system.

The government has promised major reform amid reports that councils are struggling to provide enough support to cope with the ageing population.

The latest research, published in the Lancet, looked at not just the growth in the numbers of older people but also how many of those years were spent needing daily care.

Between 1991 and 2011, life expectancy increased by more than four years for both men and women to 82.6 and 85.6 respectively.

But the number of those years spent with substantial care needs rose much more rapidly, from 1.1 to 2.4 for men and 1.6 to three for women.

Looking ahead to 2025, it means there will be another 350,000 people with high care needs, the researchers predicted.

Not all of those will need to be in care homes, but the researchers said the number of places would still need to rise by a third to cope.

Sir Andrew Dilnot, from Oxford University, who has advised the government on social care, said the findings suggested spending on older people would need to “increase substantially and quickly”.

Janet Morrison, chief executive of the charity Independent Age, added: “This report is further evidence, if it were needed, that the government must act urgently to put in place a sustainable social care system that is able to meet the demands of an ageing population.”

Apology over Indian blood donation ’embarrassment’

Blood donations

The Blood Transfusion Service has apologised after 120 members of the Indian community were turned away from giving blood.

The blood drive was organised specifically for the Indian community last year, but confusion over criteria meant .

Community leaders said they were left feeling “hugely embarrassed”.

The Northern Ireland Blood transfusion Service (NIBTS) said there had been a “breakdown in communications”.

“NIBTS fully accepts and apologises for the upset and inconvenience caused to those who attended the session and were unable to donate,” it said.

It said the error was caused by confusion regarding “travel criteria for donors” ,and said “lessons learnt have been disseminated across the organisation to the relevant staff”.

The BBC has obtained a copy of an internal report and staff e-mails from the NIBTS, through a freedom of information request.


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Surendran Varma said donations were refused on the basis of ethnic background rather than exposure to a malaria-risk zone

Dr Umesh Vijayam helped to organise the event, which took place last year, and said people had travelled from as far away as Londonderry, Bangor and Newry to take part.

“Around 30 people had already arrived, with many more on their way,” he said.

“One of my friends went in to donate blood, he was very enthusiastic, he was first.

“They asked had he taken a malaria test since he was from India, a malaria-risk country.”

Dr Vijayam said it was then that they realised that there was a problem.

Surendran Varma was also one of the group that organised the event and said that the community “wanted to do something unique”.

Mr Varma said they had been campaigning for almost 10 months to recruit Indian donors by handling out pamphlets at three or four big Indian community events.

“It was the first blood drive for the Indian community and many people were excited,” he said.

He said that many people had taken a half day off work to donate blood and they planned to have a celebration meal afterwards.

Mr Varma said it was “really shocking and embarrassing” when they were told they could not donate.

“Initially it was annoying, why did they not communicate with us what was needed?” he said.

“I had to call all my friends that hadn’t arrived and tell them not to come.

“They didn’t check our passport to see if we were an Indian citizen or a British citizen. They just looked at our face.

“They never checked if you had travelled to India, it was just a blanket ‘no’.”


The emails between the former donor services manager, Charles Kinney, and the organisations medical director, Kathryn Maguire, point out that the organisation should have anticipated the problems in advance.

A NIBTS spokesperson told the BBC all donors were assessed individually and some Malarial Antibody Tests (MAT) were taken.

They have also clarified some of the criteria for Indian people to donate blood:

  • If the donor was born in India and spent a minimum of six months in the country, a Malarial Antibody Test will be required
  • If the person has never been a resident, i.e. just a visitor, the Geographical Disease Risk Index (GDRI) will be referred to in order to assess risk

NIBTS said that for all other donors, if it had been between four and 12 months since their return from a malaria-endemic area, a validated test for malarial antibody must be performed.

Japanese fungus spreading in UK hospitals

Disinfecting hands

More than 200 patients in England have been infected or contaminated with a drug-resistant fungus first found in Japan, health officials have confirmed.

Hospitals are on the lookout for further cases and are putting in place measures to help control any further spread of the fungus, Candida auris.

Public Health England says in some cases patients will have no symptoms, but the infection can cause serious bloodstream and wound infections.

So far, no UK patient has died from it.

The first UK case emerged in 2013. Since then, infection rates have been going up – although it remains rare.

Candida auris is proving hard to stop because it has developed some resistance to the drug doctors normally use against it.

As of July, 20 separate NHS trusts and independent hospitals in the UK had detected Candida auris.

More than 35 other hospitals have had patients known to be colonised with Candida auris transferred to them.

Three hospitals have seen large outbreaks that have been difficult to control, despite intensive infection prevention and control measures.

These outbreaks have now been declared over, however, Public Health England says.


Dr Colin Brown, from Public Health England’s national infection service, said most of the UK cases had been detected by screening, rather than investigations for patients with symptoms. But 27 patients have developed bloodstream infections.

“Our enhanced surveillance shows a low risk to patients in healthcare settings. Most cases detected have not shown symptoms or developed an infection as a result of the fungus.

“NHS hospitals that have experienced outbreaks of Candida auris have not found it to be the cause of death in any patients.”

He said PHE had updated its infection-control guidance for hospitals and nursing homes on managing outbreaks of Candida auris, together with who may have the fungal infection.


What is Candida auris?

It belongs to a family of fungi or yeasts that live on the skin and inside the human body.

A more common “cousin” in this family is Candida albicans, which causes the yeast infection thrush.

Candida auris was first identified in 2009 in a patient from Japan.

Hospital outbreaks have since been reported in the United States, India, Pakistan, Venezuela, Colombia, Israel, Oman, South Africa and Spain, as well as the UK.


Some people can carry the infection without having any symptoms or being unwell.

Patients in hospital who catch it may become sick, although infections are still usually minor.

Candida auris can cause more serious bloodstream and wound infections, however.

Nursing staff can take swabs from different parts of a patient’s body to check if Candida auris is present.


That is still being investigated, but experts think it is spread by contact from person to person, on people’s hands, clothing or on bits of medical equipment.

Contamination is quick – several hospitals have reported it takes as little as four hours from initial exposure.


Spread can be limited by good hygiene – keeping hands clean by frequent hand washing and using alcohol gel.

If a patient in hospital is found to be infected, their visitors may be asked to wear a gown, plastic aprons and gloves.

Antifungal medicines can treat the infection, despite the strain of Candida auris in the UK having some resistance to some of these drugs.

A biosafety Investigation Unit at Porton Down, the government’s military research base, is testing a variety of disinfectants and antiseptics to see if they can kill the infection.